Provider Demographics
NPI:1619268703
Name:HUBER, LINDA K (PMHCNS-BC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:HUBER
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4321 WASHINGTON MEDICAL PLAZA III
Mailing Address - Street 2:SUITE 5100
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111
Mailing Address - Country:US
Mailing Address - Phone:816-932-5912
Mailing Address - Fax:816-932-5189
Practice Address - Street 1:4321 WASHINGTON MEDICAL PLAZA III
Practice Address - Street 2:SUITE 5100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111
Practice Address - Country:US
Practice Address - Phone:816-932-5912
Practice Address - Fax:816-932-5189
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO070423364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult